Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0049 - Renal Disease Program, Administrative Procedure for End Stage
Chapter 4 - DENIAL OF APPLICATION; MODIFICATION, SUSPENSION OR TERMINATION OF RECIPIENT BENEFITS (REPEALED)
Section 4-2 - Statement of Purpose
Current through September 21, 2024
These rules and regulations are adopted to implement the Department's authority to deny an applicant benefits or modify, suspend or terminate a recipient's benefits under the Program for the following reasons:
(a) The applicant/recipient is not a resident of the State of Wyoming;
(b) The applicant/recipient fails or refuses to provide the required annual update or submits documents required in support of the annual update which contain false statements of fact designed to enhance that person's eligibility status for Program benefits;
(c) The applicant/recipient submits an application or any documents required in support of the application which contains false statements of fact designed to enhance that person's eligjbility status for Program benefits;
(d) The applicant/recipient does not have end stage renal disease, regains kidney function, or voluntarily stops treatment for end stage renal disease;
(e) The recipient refuses to reimburse the Department after being notified of third party benefits or recipient's reimbursement obligation;
(f) The recipient notifies the Program in writing that he no longer wishes to claim Program benefits;
(g) The applicant/recipient dies;
(h) The recipient submits false claims for benefits to the Program;
(i) The Program has not paid a claim for benefits on behalf of the recipient during any period of twelve (12) consecutive months;
(j) Program funds are reduced;
(k) Funds allocated for payments on behalf of the recipient are exhausted.
